Peripheral Vascular Disease Flashcards
There are how many types of blood vessels?
5
What are the types of blood vessels?
Veins
Venules
Capillaries
Arteries
Arterioles
Blood vessels that carry deoxygenated blood, Thin, less muscular wall
Veins/ venules
Blood vessel with 3 less defined layers
Veins/ venules
Blood vessels that distend more than arteries
Veins/ venules
Blood vessels with valves to prevent backward flow
Veins/ venules
75% total blood volume is in the
veins
SNS can stimulate constriction of these blood vessels
veins
These blood vessels use contraction of skeletal muscles to move blood flow
Veins/ venules
Single layer blood vessels with thin walls that permits transport
Capillaries
Blood vessels where oxygen and CO2 exchange
Capillaries
Blood vessels that carry oxygen rich blood
Arteries/Arterioles
Blood vessels with thick walls and three distinct layers
Arteries/Arterioles
The inner layers of the arteries/ arterioles are
smooth
The middle layer of the arteries/ arterioles
dilates/constricts
The outer layer of the arteries/ arterioles
Anchor vessels
Blood vessels where chemical, hormonal, neuronal factors effect constriction and dilation
Arteries/Arterioles
The lymphatic system collects lymph from tissues and organs and transports into
venous circulation
Permeable to large molecules ie: protein
lymph
Muscular contraction of walls and tissue propels lymph towards
venous drainage
Excess fluid from the arterial-venous filtration is absorbed by
lymphatic circulation
Runs alongside the capillary bed
lymphatic system
Hardening of arteries
Arteriosclerosis
Plaque formation
Atherosclerosis
Injury to endothelium causes platelets and monocytes
to aggregate
Two types of lesions
Fatty streaks
fibrous plaques
Decreased flow of oxygen rich blood due to narrowed arterial lumen is caused by
Arteriosclerosis and atherosclerosis
Increased metabolic demands caused by arteriosclerosis and atherosclerosis leads to
ischemia
ischemia
an inadequate blood supply to an organ or part of the body causing pain
Smoking increases platelet aggregation leading to
clot formation
aggregation
clustering
Atherosclerosis clinical manifestations:
Coronary arteries
angina, MI
Atherosclerosis clinical manifestations:
Cerebral arteries
Stroke , TIA’s
Atherosclerosis clinical manifestations:
Aorta
aneurysm
Atherosclerosis of Extremities
Peripheral Artery Disease
Number 1 sign of Peripheral Artery Disease
Intermittent claudication
Pain caused by too little blood flow to muscles during exercise.
Claudication
What do the legs/feet look like with PAD?
Thin brittle shiny skin on legs/feet
Loss of hair on legs
Dependent rubor
Thickened toenails
What might you find while assessing legs/feet with PAD?
Diminished peripheral pulses
Prolonged capillary refill
Patients with advanced PAD will feel
Pain at rest
Patients with PAD may have what kind of ulcers?
dry, necrotic, delayed healing
Pain is distal to
diseased artery
Claudication may begin shortly after
activity begins
PAD:
Elevating legs makes pain _____ and foot becomes _____
worse and foot becomes pale
PAD:
Dangling (dependent) legs does what to pain? What color do the feet turn?
relieves pain – foot becomes deep red (rubor)
PAD:
Med that improves blood flow
Cilostazol
Onychomycosis is
A fungal infection of the nail
PAD diagnostic tests:
Sees blood flow in legs
Doppler study
PAD diagnostic tests:
Testing for claudication
Treadmill test
PAD diagnostic tests:
combines both ultrasound and Doppler procedures. The result is live, high-definition pictures of blood flow.
Duplex ultrasound
PAD diagnostic tests:
Non-invasive test performed by measuring the systolic blood pressure from both brachial arteries and from both the dorsalis pedis and posterior tibial arteries after the patient has been at rest in the supine position for 10 minutes
Arterial Brachial Index (ABI)
What patients need ABI?
Pt with diminished pulses
50 y or older with history of diabetes
Patients with an ABI <0.9 =
PAD
NORMAL ABI is
1 – 1.4
NORMAL ABI is because feet arterial BP
Is slightly higher than brachial
Cilostazol should enable pt to
walk longer periods of time without pain
Pt will aortoiliac disease –
assess femoral pulse
Carbon monoxide from tobacco binds to
hemoglobin depriving tissues of oxygen
Fluid exchange across capillary wall based on
hydrostatic and osmotic forces.
Hydrostatic pressure at arterial end is higher then
venous
Hydrostatic pressure at arterial end drives fluid into the
tissue space
At venous end of capillary, osmotic forces
reabsorb fluid back into capillary.
Any left over fluid goes into
lymphatic vessels
Interpretation of ABI:
> 1.30
Noncompressible
Interpretation of ABI:
0.41 - 0.90
Mid-Moderate PAD
Interpretation of ABI:
0.00 - 0.40
Severe PAD
PAD patient teaching
Promote exercise, dangle legs, do not elevated, no crossing legs, no heating pads
Weight reduction, smoking cessation, reduce BP
Platelet Inhibitors prevent
clots